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{
"id": 1484990,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1484990/?format=api",
"text_counter": 252,
"type": "speech",
"speaker_name": "Seme, ODM",
"speaker_title": "Hon. (Dr) James Nyikal",
"speaker": null,
"content": "to use medication. That community health worker is now linked to Level II hospital, or what used to be dispensaries; and to Level II hospitals, which are now health centres. In a working referral system as intended, they will advise the people on when to seek medical care. Where there is need to offer support, like in the delivery of babies, they will accompany the mother to the lowest level health facilities. As currently structured, they also seek advice and are regularly advised by community health extension workers, who are themselves formerly trained community health workers. What is their role in our country? We are all talking about primary healthcare. What does primary healthcare mean? We look at diseases from the point of the initial event that causes it. As I said earlier, people do not get sick in hospitals, but at home. We have what we call ‘social determinants of health.’ These are the factors that make you sick. You get sick due to your relationship with the environment. If you drink contaminated water and you get cholera, the germ that causes cholera is what we normally say is the cause of the disease. But the real cause of the disease is actually lack of clean water. Social determinants are the causes of diseases. If you get cancer, you may have been exposed to disease-causing agents at the place where you work, for example, if you work with dyes. Perhaps, the food you eat may be the cause. The cause could also be farming inputs that you are exposed to. It is that exposure which is the actual cause. Hon. Temporary Speaker, if you worked in an industry where you dealt with asbestos and you got lung cancer, although asbestos is probably the agent that causes lung cancer, it is the work environment that caused the disease. If you live in a place where kids swim in pools of water and they get schistosomiasis, although the bilharzia germ is the cause of the schistosomiasis, the real cause is swimming in those pools of water. If you eat food with a lot of sugar and fat, and you eventually end up with hypertension, obesity or diabetes; the real cause is the food that you eat. If you live a sedentary lifestyle, whatever disease you get is secondary. The real cause is your lifestyle. The community health workers will advise the members of the community on how to live, where they should live, what food they should eat, and what steps they should take to prevent sickness. That is extremely important. Those people will be key in early detection of diseases. Let us talk about skin cancer. You may have a little nodule on your skin which, if excised, would ensure that you are okay for the rest of your life. However, it will definitely kill you if it is discovered at a late stage. So, early detection is the key to beating diseases like cervical or breast cancer. If women went for regular check-ups and they were taught how to examine their breasts by the health workers, those diseases would be detected early and excised. Treatment would not be expensive. Early detection is extremely important and, along with it, early treatment, which is cheap. It is not only early treatment that is important. Even a faster referral system would help. People take a long time to get treatment when they get a certain illness and they do not know what to do. Therefore, if there is somebody who is advising them early, they will seek treatment. The Mover was talking of immunisation and antenatal care. The community health workers will advise. I ask for just two more minutes because this is dear to me. If the people have been treated in hospital, there are times they can be sent home on follow-up treatment. Those people will advise on how you can use your drugs. How do we link it to the health system? We are talking of primary health care. We now even have the Primary Healthcare Fund under SHA. If we do not have those people well-trained and establish how they will work and the structures in which they will work, that Fund will not help us."
}